Managing Aches and Pains

Dr Low Wye Mun runs the Sports Medicine Clinic at the Pacific Healthcare Specialist Centre. A Fellow of the American College of Sports Medicine, read on as he shares with you insights into the causes aches and pain, and how most conditions can be successfully managed and prevented.

Who are the people you see in your Sports Medicine Clinic?

Most of the people I see have injuries arising from their passionate participation in exercise or sports. But quite a number of people come in with aches and pain that arise from hours of work in an office or home, and not from sports.

What are the main injuries, aches or pain that you see and what causes them?

These are related to the parts of the body that relate to activity and posture: muscles, tendons, joints and ligaments, as well as bones. Some of these are caused acute injuries but quite a number are more progressive and chronic in nature. A common feature in all of these conditions is doing too much, too soon, and being seen by a doctor too late!

Why would someone be “too late” in seeking medical treatment?

The most common reason I am given is that they were afraid that I would tell them to stop their exercise or sport! Another reason is that of being too busy and hoping the ache or pain would take care of itself.

What steps do you take in managing such conditions or injuries?

A systematic 6 steps that all start with a “C”:

1. CONFRONT. Many people are a little scared to know what the injury or condition is, or can’t accept that it is something of significance. So the first step is to convince them that if the ache or pain has lasted for more than 2 weeks and is affecting daily or exercise activity, there is a real issue that needs to be taken care of.

2. CLARITY. This involves understanding what might have caused the condition or injury as this helps make the correct diagnosis, and sets the stage for providing injury prevention advice later. The diagnosis is based on a detailed discussion of the problem being faced and then a careful physical check on the aching, painful or injured area.

3. CONFIRMATION. With some conditions, a final confirmation of the diagnosis may need some form of medical test. This ranges from Xrays and diagnostic ultrasound scanning all the way to MRI scanning. These can be helpful in not only making the diagnosis but determining the severity of an injury as well.

4. CONFIDENCE. The next step is then to develop a good plan of treatment. This involves not just medication and physiotherapy, but careful advice on what activities or exercise to avoid. Equally important is the setting of exercise and sports goals in line with the injury healing, as well as planning ongoing exercise that maintains fitness, health, and yes, happiness!

5. CARE. The last step involves review of the cause or causes of the injury and the development of prevention steps for the future. This can range from the way sports training is planned or embarked on, to sports skills and equipment changes (eg. type of running shoes to use). A re-setting of sports event participation plans may be needed. Or starting up helpful exercise programmes such as Pilates or yoga for preventive health as well as improved performance.

Finally, what is the most common thing that your patients say to you?

Apart from the first challenge of “You’re not going to ask me to stop exercising are you?” it would be “I wish I had come to see you earlier”!!